| NPI | 1700291119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME E FERNANDEZ Clinic/Program Administrator 323-223-6146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |